This invention relates to the field of oral surgery, and more specifically, periodontal surgery. The invention provides a method and appliance for promoting the healing of oral tissues including bone, which have been damaged by disease.
Periodontal disease occurs when bacteria (plaque) proliferate on the teeth and gums. If the bacteria are allowed to remain, they eventually cause inflammation of the gums and may destroy gum tissue. The condition worsens when the bacterial infection attacks the underlying bone. In many cases, the periodontal infection is advanced and some of the underlying bone will have been destroyed before the patient seeks treatment.
The body may regenerate bone tissue lost to periodontal disease. It is known in the art that the cell type that repopulates the root surface after periodontal surgery will determine the type of attachment that ultimately forms. Animal studies have shown showing different healing responses occurred when various periodontal tissues came into contact with the root surface.
More rapid regeneration of bone tissue may be promoted by isolating the bone from other proximate tissues and especially from the gum tissue overlying the bone. A physical barrier may be used to separate the bone tissue from the surrounding tissues and thus promote selective cell repopulation of the root surface in turn facilitating periodontal regeneration. A barrier may also be used to promote regeneration of other oral tissues, such as the cementum, a layer on the tooth, and the periodontal ligament, which joins the tooth to the bone. The barrier facilitates regeneration of the isolated tissue by preventing surrounding gum tissues from filling empty space formerly occupied by bone and or periodontal ligament. The invagination by gum tissue, if permitted, prevents the bone from restoring itself to its former condition and configuration. The barrier thus promotes the regeneration of the damaged bone, cementum, and periodontal ligament over the growth of other oral tissues, specifically gum tissue.
It has been demonstrated that a variety of membranes can be used to facilitate the regeneration of the periodontal attachment apparatus. The barrier accepted as the standard in the field is made of expanded polytetrafluorethylene (ePTFE). The barrier is placed as part of the original periodontal surgical procedure.
The non-absorbable nature of the ePTFE membrane requires a second surgical procedure for removal of the barrier. This removal is usually scheduled 4-8 weeks after the insertion of the membrane, and is usually accomplished under local anesthetic. Surgical removal of the membrane poses potential risk to the newly regenerated tissue as well as surgical trauma to the patient. This risk and trauma may be eliminated by adoption of a non-surgical approach to membrane removal.
A variety of absorbable membranes have been developed which do not require removal. However, practitioners skilled in the art consider use of the ePTFE membrane most likely to yield the most optimal outcome for tissue regeneration. The instant invention provides a periodontal barrier incorporating a membrane retrieval device that will facilitate non-surgical removal of the non-absorbable barrier membrane.
Non-absorbable barriers have been shown to produce superior tissue regeneration and provide more durable and long lasting protection in covering blood clots. The invention reduces the need for extensive surgical removal of the barrier thus reducing (1) the risk to the newly regenerated tissue, (2) additional surgical trauma to the patient and (3) enables better utilization of the clinicians time.